19. Ending Endometriosis

Endometriosis is far more common than most probably realize, and the fact that it often goes undiagnosed for an average of 10 years is eye-opening. The severity of its symptoms makes it clear that better awareness and management tools are essential. With the rise of technology and AI, apps like Endo45 are meeting this need, allowing people to track symptoms and take a more active role in their healthcare. Just as there’s an app for everything, it makes sense to integrate this approach into condition management. By empowering patients with data, these tools enhance the quality and efficiency of time spent with doctors, ultimately improving care and outcomes.

 

Resources:

Check out Endo45 and download their app @ https://www.endo45.co.nz/

 

Episode Transcript

(00:25):
This is Healthcare Uprising.
We are here to shine a light on the innovators implementing positive change in Americanhealthcare.
In the patient experience stories, good and bad, that can help others navigate thesometimes overwhelmingly complex American healthcare system.

(00:46):
Welcome to the Uprising.
We're not doctors and we don't play one on TV.
If you need medical advice, consult with your physician or healthcare professional.
Alright, hello Health Heads, welcome and thank you for checking in to this dose of thehealthcare uprising.

(01:10):
I'm your producer in the back, Jeremy Carr, here with your host in the front row, HeatherPierce.
So why you tell them what's on the agenda for today, Heather?
m
we are meeting with Juliet Oliver, is the CEO and founder of Endo 45.
Her story is one about the journey that spiraled from the depths of endometriosis to thecreation of Endo 45, a beacon of hope for all endo warriors out there.

(01:34):
But her career started in the male dominant energy industry, where she worked as anengineer for about 15 years.
Her ability to problem solve was a natural transition to building Endo 45, solving forendometriosis.
Julia is a New Zealand native and an emerging member and voice in the hashtag FemTechuniverse with her mission to make living with endometriosis more possible and maybe even

(01:57):
reaching endo remission just like she has for the last eight years.
Yeah, it's pretty cool.
Someone came all the way from New Zealand to be on our podcast and it is one of myfavorite accents as well.
So, without further ado, let's hear our conversation with Juliet from Endo 45.

(02:20):
Hi, and welcome to the Healthcare Uprising podcast.
Today we have Juliet Oliver with Endo 45.
Welcome to the show, Juliet.
Thank you.
Great.
Well, let's just jump right in here.
We like to kind of kick things off and get your background and your experience.
What drove you to build Endo 45 and just kind of the origins about it?

(02:43):
What's the story?
Tell us about yourself.
Yeah, sure.
So it's obviously birth from my journey with severe endometriosis.
I'm actually an engineer by trade.
I'm not from health or tech.
And I guess it was going in deep as an engineer into really what was happening to my bodyum and really not taking nothing's wrong for an answer, not taking the dismissal

(03:10):
dismissals for an answer and not taking just take the pill and go home as an answer andreally wanting to understand
Like, what's really going on?
What's really going wrong?
And can I somehow reshape that narrative for myself?
And so I sort of reverse engineered my own endo, cracked my endo code and have been livingpain and symptom free for eight years now, started a family.

(03:36):
So I'm in endometriosis remission, which is pretty unheard of for a lot of people, but ispossible to always feel better than you do today, I truly believe.
I started to get really frustrated with how there wasn't a one-stop shop for the gold Ihad uncovered in the steep journey, the evidence I had uncovered, the practitioners I had

(03:57):
spoken to and how it's all supported to help you with a chronic inflammatory disease likeendometriosis.
And so I just wanted to get that out into the world.
And most importantly, I wanted to make an impact and make sure I was making an impact inpeople's lives.
So we built the Endo 45 app.
And yeah, I left my energy career and I'm now sort of at the forefront of FemTech in thisspace.

(04:23):
And it's exciting.
It's really exciting.
So how long ago was Endo 45 established?
A year.
So last March for Endo Month.
Yeah.
So you're really early on this journey.
That's exciting.
Well, I'm thrilled that you're on the show because
Uh, especially, uh, you know, fem tech is, is just women's health is something that I'mreally passionate about.

(04:48):
And it's definitely a lane we are leaning into here on the healthcare uprising.
So this is really perfect.
as we're recording, is women's history month.
Um, and sorry, and it's also end of month you mentioned as well.
how timely of us to be, um, kind of touching on all the very current relevant things rightnow.

(05:12):
Um, and staying in that, that kind of topic there, women's health issues, uh, they'vebecome, we're having our moment, right?
I feel like that's finally, um, getting the recognition and, and, and the attention, um,that we've needed for a long time, endometriosis being obviously a major, female health,

(05:33):
um, issue.
Um, what do you think's changed?
Like what, what do you think's been changing just in general?
And then maybe even for endometriosis, endometriosis itself.
I sufferers have found their voice, right?
And they've found a platform to raise that voice on and get really loud.
And when we get loud, we get heard.
And it's unfortunate that the system, be it research, medical, corporate, can't move asfast as say like a movement or a community can, but it's really good to see that slowly

(06:07):
but surely the lights turning on in the city and...
everything from new ways of diagnosing endometriosis to new treatments are beingresearched and funded slowly but surely and that there's just a really large, I guess,
sufferer campaign going on with the world in terms of.

(06:32):
We should be in control of our own bodies.
We can be in control of our own bodies.
Now listen up, we need your help to do that.
And I think that spans not only endometriosis, but yeah, like you say, woman's health.
And we are the best measure of our own health and what's going on in our bodies.
And we need to be listened to and heard, and then someone's gotta help us connect the dotswith the science.

(06:55):
And that's really what we expect from practitioners, the medical system.
anyone, any holistic practitioner or specialist we see.
And so, yeah, you see more and more of them cropping up that are in particularendometriosis specialists.
And I would always advocate that those are the right people to go to because those are thepeople that are truly gonna listen, truly gonna understand and be able to help you connect

(07:18):
the dots with what's going on.
Can I pull back just for a second here and ask the most basic of questions?
Can you tell me, uh our listeners out there who aren't familiar, much like myself, what isendometriosis?
And more importantly, what are the effects?
What are the main symptoms?

(07:38):
And why is it so important that we address this as an issue in health?
Yeah.
So endometriosis is really quite prevalent.
It's between one and 10 and one and seven.
Some of the new stats are one in seven individuals identified female at birth.
So it's continuing to rise.
um So that's like over 3 million people globally.

(08:01):
That's really high number.
Yeah.
And before we get into the what is it, it's probably important to start with the otherside of question, is what does it do to someone?
It's a really debilitating chronic inflammatory disease.
often wrapped in a lot of chronic pain, not only in the pelvic region, but also body-wide.

(08:22):
It comes with a number of lovely other add-on symptoms like endo belly, which is chronicgut dysbiosis or distension of the belly, chronic fatigue, like zombie level fatigue,
crazy menstrual cycles, or really abnormal periods, and generally leaving people

(08:44):
very washed up, very wiped out.
And to be honest, the string of symptoms are a few pages long that you could possibly havealongside this disease.
Because it basically hijacks the systems of the body and rages war, like a chronicinflammatory war on your body.
So the systems that are there to support you every day, your nervous system, your guthealth, your immune system, your hepatic system, they are...

(09:10):
waging this war.
And so they are tired, they are under-resourced, and they are extremely dysfunctional.
And so that's why you end up with a strong array of symptoms and kind of it being what wecall now a whole body disease, because it literally can affect someone from like their
brain to their bum.
Not just in the fact that these endometriosis lesions, which I'll get into, can growanywhere from your brain to your bum, but because this kind of war that's being waged zaps

(09:38):
your entire body.
um And at least people really washed up and almost unable to participate in life sometimesand certainly not bring their best.
So yeah.
And then the origin.
Yeah, it is really.
It's like a snowball effect, like the worse it gets, the worse it gets, the worse it gets.
And just more and more symptoms as you go.

(10:00):
Yeah, there's a huge mental health aspect to that as well.
it's like the more it impacts you, the less you do, the louder the clock on the wall gets,know, the more, you know, the lower the mood, the more anxiety, the more depression and it
just feeds, it's a self-feeding cycle.
um As well as there now being some interesting science around the endometriosis brain andhow constant chronic pain can actually, you know, really impact the pathways in your mind.

(10:26):
not only creating pain sensitization so that you feel pain more than a normal personwould, but also that it really starts to lower all the things we need to be happy.
It really starts to shift us into that depressive state.
um And so the origins of endometriosis are a little bit unknown, but there's a lot ofgreat new research coming.

(10:51):
And it's really what we know about it is it's really when
these cells, we call them endometrial like cells.
So similar to those found in the lining of the uterus, which are supposed to be there,they have a great job in that process of menstruating every month.
These cells similar are found outside the uterus.
Now they can actually be found in anyone, even men, and they're normally quite harmless.

(11:15):
They sort of just sift around whatever, cares?
But it's when these cells get meet with a life of
chronic inflammation, potentially some epigenetic factors that get turned on, some toxinspotentially from your environment or leaking from your gut that you create this perfect
storm.
And basically it interacts with that cell and that cell transforms and goes rogue and whatwe call endo-like.

(11:42):
It gets really, really nasty.
It can evade your immune system and actually convince your immune system to not clear itout like your immune system would like to, but
welcome it to the body party, hook it up with blood supply, oxygen, and enable the cell togrow into what we call endometriosis, or what we know are endometriosis lesions.

(12:04):
And these lesions can grow anywhere in your pelvic region and around the body.
They're great at invading small spaces.
They're great at fusing organs together and also tapping into your nerves.
So just, and ultimately leaving you with a large amount of
chronic pain and obviously some internal lesions, just to be clear.

(12:27):
Yes.
And also I'm not anything you would see physically.
No, no.
And another great point about endo is that it's a completely silent disease in the sensethat there's no nothing you can see that's going on with the human and often why it's
overlooked and dismissed for so long.

(12:48):
On top of that, it's very hard to see with any sort of normal ultrasound
scan and very hard for someone that's not experienced in it or specialized in it to putthe symptoms that you get with it all together and to be able to label it as endo because
individually a lot of those symptoms might get labeled as just IBS or mental health issuesor bad periods.

(13:12):
yeah, it's like separate just separate conditions not yeah okay.
Very tricky.
very tricky invasive disease, not only for your body.
Yeah, as I was they're for different providers too, right?
So then you start having that kind of disconnect in your care, I imagine, uh when youdon't have one physician or specialist treating you for all of those things.

(13:38):
Yeah, a hundred percent.
There are some stats out there that say people bounce between five to 10 practitionersbefore they get their diagnosis.
And it's also why it takes an average of 10 years to get an official diagnosis as well.
10 years?
Because one of the main or the gold standard for diagnosis as well is laparoscopicsurgery.

(14:00):
So not only do you have to kind of find someone who's taking you seriously, do you have toget a suspected endo diagnosis, but then you have to get on a wait list for surgery, get
surgery, have it confirmed.
So yeah, it's a pretty long journey.
and a really long time for people to be just operating with so much chronic pain andinflammation in their bodies.

(14:24):
And yeah, it takes a lot of resilience.
And that's why it's...
And it's common.
That's like a lot of people walking around with this.
In any friend group, in any work room, in any meeting, like you're gonna know someone,like someone in that space will know.

(14:45):
And you never hear it.
Like I've never, I didn't know what it was before this interview.
That's crazy.
I had no idea it was going to be that common of a thing.
So is that what end 045 is about though?
You're like, are you working on being able to get an actual proper diagnosis and inefficient manner?

(15:07):
Is that one of your goals?
So we come at it from more of the everything else you can do to take control of yourhealth.
It's, guess it's my goal and what led me to um now live in endometriosis formation or livepain and symptom free.
And it's what the evidence supports and what practitioners wish you would know when you goon your medical journey, which is like, there's a real time and place for the right

(15:33):
surgery at the right time with the right specialist.
um
hormones and potentially other things that need to come into play.
But to actually get to a place of living well with the disease, because there is nomedical cure, it is a lifelong disease.
It requires you to nourish those systems of the body that I said would be completelydysfunctional.

(15:54):
It requires you to nourish those into a place of homeostasis again, so they can startfighting for you rather than actually against you and fueling the disease.
And so,
our goal or our product or the Endo 45 app is about taking you on that journey, giving youeverything that you need to say what we call, become what we call EndoFit.

(16:15):
And that's a place where endometriosis is understood.
So you've now got the full foundation of what it's all about and what's going on in yourbody.
It's managed.
So you've got some really good managing techniques and tools that are gonna help you getyou out of zombie mode, at least for a little bit.
So you can start really like,
functioning in life and doing some things towards bettering your health and then alsowhere we say it makes basically you get to a place where it doesn't hold you back and

(16:42):
that's where you're really starting to live well with the disease and you're starting toreclaim your version of your best self and that might not be remission for everyone and I
totally respect that there are like 65 over 65 different types of endometriosis out thereeveryone's at a different level of severity as well in terms of their journey, so

(17:03):
But I do believe that regardless of that, those two factors, everyone can feel better thanyou do today using what's in our app and yeah, going on the journey with it.
So the app itself, if I was a user of that app, am I tracking, am I using it for trackingto maybe find triggers for certain symptoms?

(17:29):
Do the people that are using this app is...
Does it help for basically like if they go in to see their doctor and I actually have aquestion about that too is like who is like your typical treating physician for
endometriosis?
um So yeah, like maybe share a little bit more about em some of the specifics of the app,like how it helps.
And um obviously you've used your own journey, your own like inputs, right?

(17:54):
To create this app to help keep you in remission too, right?
Like I imagine there's probably a lot of
kind of learned experience there.
Yeah, 100%.
um So basically the app, yes, it is a place to track your endometriosis symptoms, keep anote of anything that is triggering you and to be able to really see the woods from the

(18:15):
trees on, you know, one day from the next one month to the next, which can be really hardwhen you're in that deep place with endo.
m On top of that, it's like I say, it's everything known to help that's proven to help
evidence backed and practitioner supported.
And we kind of serve that up to you as well.
So when you come into the app, you tell us what your goals are, and we give you somerecommended roadmap and a path or a place to start.

(18:42):
And you can just go in and utilize what we call the quick hits, which help you in the hereand now, manage your pain and symptoms, learn, which is like I said, get really educated
on what's actually happening in your body, because it's not stuff that's covered in the 15minutes you have with your specialist or your doctor.
And then we have the gold in it, which is the ability to build, track and master theseendo fighting healthy habits, which is where the rubber really hits the road and we start

(19:10):
to shift the dial on how people truly feel.
And we've tried to make those like the most simplest things everyone could do, but alsoprobably the things that people really don't realize are contributing to intensifying
symptoms or.
proliferating the disease that they do every day.
So yeah, it's just bringing all that together at someone's fingertips so they can go onthat journey.

(19:35):
And yes, like you said, it is all my goal, but we also have other successful Endo 45, whatI call EndoFit pros who have become EndoFit and reached their best self because in the app
you get an EndoFit score and that score will show you over time just how well you'redoing.
And you can drill down in that score into your different pillars of health and see whichones are doing better than others.

(20:00):
But ultimately that's your buddy and your guide to keep you motivated, to keep you goingand to show you that actually, even though you're still feeling terrible, you are slowly
getting better and things are starting to tick up.
um That's good.
Gives you a little bit of hope.
Yeah, it makes it kind of a game keeping score like that and stuff that always givespeople a little more motivation to stay involved.

(20:26):
Good psychology.
And I asked about the physician piece of this too.
uh I feel like I should know the answer to this.
It's like, of course it's a gynecologist, but is it like, who would be, is it primary carephysicians?
Because it's so misunderstood.
Could it be an internist?
I mean, I guess it could be the multitude of physicians, but I'd love to hear about that alittle bit more.

(20:50):
So more often than not, people will end up at a gynecologist because they're presentingwith pelvic.
because they're potentially presenting with quite abnormal obscure periods, menstrualcycles, and some hormone related issues.
more often than not, that's an okay step to take.
You'll get a normal probably pelvic ultrasound, which is gonna check for anything, anymajor abnormalities, any maybe a major cyst on your ovary.

(21:19):
You might be able to see a big...
endometrioma, which is a type of endometriosis cyst on the ovary, but those simple scansand checks by a non-specialized gynecologist aren't going to get you an endometriosis
diagnosis.
So a lot of people at that point, unfortunately, the gynecologists will use the tools thatthey have at hand to help the person manage their symptoms.

(21:45):
So they're going to say something like, try hormones, try birth control, try the pill.
um or try even as far as induced menopause to lessen the symptoms and kind of just sendyou on your way.
um The unfortunate nature about that is that you don't get the diagnosis.
You end up experimenting with hormones, which might not be the right place for you tostart or they may not work for you.

(22:11):
And you're still not any clearer around what you have and then how severe what you haveis.
Like if you have endometriosis, where it is in your body,
what's it's impacting and affecting.
So the drive really needs to be for those, I guess what I would call frontlinegynecologists to recognize and notice when someone needs to go for further more in-depth

(22:36):
investigation.
There are other ultra scans that in the hands of and in the eyes of specialists can detectcertain forms of endometriosis.
And then there's obviously like, if it's the right time for you and the right approach.
getting surgery and getting the diagnosis through that means, but also then having whatthey can removed of the disease, which gives you a bit of a sort of a new starting point

(23:03):
with where the lesions are in your body.
Okay.
As you're talking to us thinking, well, we know that it's a very hard condition todiagnose, know, 10 years bonkers to me.
What a terrible, like that's horrible.
I can't even imagine.

(23:24):
I, I'm wondering, is this kind of like curious, would the endo 45 app be good for somebodywho hasn't been diagnosed, but has a pretty good feeling.
They probably have endometriosis.
I have to imagine once you start kind of tracking and kind of listening to what the app isserving up to you, that then you can take that right.

(23:45):
And go into your doctor and say, see, look, it's right here.
Have you, have you.
of people using it for that purpose and then actually helping them to get a diagnosissooner?
Yes, 100%.
It's the right thing to do.
If you even remotely suspect um because you're having interesting pelvic pain or weirdperiods, it's the right app for you.

(24:06):
And that means you're also going to be on the front foot because what you you know what wesay, prevention is the best cure, but also early intervention with endometriosis is so
essential because some people's disease
progress to levels which are bonkers, like beyond kind of repair to some degree.
And we just don't want to get there.

(24:27):
We need to nip this in the butt really early.
So the sooner you track, the sooner you can advocate for yourself.
And when you track and when it's all written down like that, no one can undermine you.
No one can undermine the fact that you pressed severe on the pain button for like 10 outof the 30 days of the month, right?

(24:48):
So it's really important to track and start learning and educating yourself, which is whatthe app can do.
And maybe realizing that a few of the things you do every month might be leading to whyyou're experiencing an abnormal amount of pain over others and could help you self manage
a bit of that pain while you go on this medical journey and be ready for surgery, which wesay, you know,

(25:16):
given that this is a chronic inflammatory disease, surgery is not a cure, it will growback.
So you wanna make that surgery last as long as possible.
You hear about these people having to go in for a new surgery like every two to threeyears.
I'm still running on my first surgery eight years later because it's all about trying toslow and prevent the regrowth.

(25:38):
And so having what we do, like what we propose in the app all in place.
will you have your surgery is kind of the best method.
Subsequently, a lot of people will time their surgery with their fertility journey.
we know that we see anecdotally that if you have the surge, if you've been havinginfertility issues, you have endometriosis excision surgery, a lot of people tend to have

(26:04):
successful pregnancies immediately following.
Like right after the surgery?
Yeah, like right after, like within a few months sometimes is like, my community anyway,and their experience, it's not a given, but it's certainly for some, a big game changer.
And what we know about all these things that we talk about to fight endo is that the flipside of that is that it's supercharging your fertility.

(26:30):
So, you know, a big preventer of
or a big enabler of infertility is how much inflammation there is in and around yourpelvic region.
If there's no physical obstruction, then it can be due to inflammation.
And so when we're fighting a chronic inflammatory disease and lowering inflammation in thebody, we're obviously like enabling fertility.

(26:53):
And so for a lot of people, that becomes a really important and very deeply purposefuljourney, right?
They finally have their why.
Like if they couldn't,
change for themselves, then they'll change for this because they really want to start afamily.
And so I think it's perfect time to be in the app, to be doing all of these things thatare within your control.

(27:18):
So within Demetrio, Jeremy, I knew I was going to say that word.
You should have heard it.
When I asked her what we were talking about today before the interview, it took her abouteight tries to say it.
Yeah.
know.
I said, I'm like, I'm just going to call it endo.
So I've been really proud of myself.
I haven't screwed it up yet, but it was, it was inevitable.

(27:40):
Um, so somebody with endometriosis, look, I got it right.
Thank you.
is, is it typical to have, um, infertility issues?
Um, is it also
typical to have any, is it considered like a high risk pregnancy when you are diagnosedwith endo and actually go through like anything around, I guess, maybe the fertility kind

(28:08):
of, I don't know, pathway for somebody like from trying to get pregnant all the way todelivery and even like post delivery, I wonder too.
Yes.
So actually infertility is only reported to happen to between about
40 to 50 % of those who suffer with endo.
So it's not a given.

(28:29):
And there is a lot of hope that you will still have, you know, a very um successfulpregnancy or pregnancies if you have endometriosis.
I probably can't speak on the high risk thing.
Obviously I'm not a practitioner or a fertility specialist.
It certainly wasn't an issue for me.
um It wasn't really um mentioned to me, but I wouldn't

(28:54):
I would suspect that if endometriosis has done a lot of contorting and changing youruterus, ovaries, flow venturbs, all of that, then there is going to be some concern and
some potential additional monitoring of that pregnancy.
One interesting thing about pregnancy and endo is that for a long, long time, people wouldalways be told, oh, just get pregnant because that stops the disease.

(29:23):
just have a baby, which is like quite interesting when you're speaking to an 18 or a 20year old and just any, you know, anyone in general around trying to, guess, force them
into strongly considering to have an early pregnancy to better When they're not ready justto get rid of something.

(29:44):
Yeah, exactly.
Seems like an extreme measure.
Burning down your house to get rid of some cockroaches.
Yeah, you know, that's like, that's a journey in itself with being told those things bypractitioners, by doctors, you know, who you want to trust and you want to follow their

(30:04):
guidance.
But what we do know is that for some, for some potentially pregnancy or post a fewpregnancies,
they will have a lessening of symptoms, but it is categorically not being confirmed, Ithink, that pregnancy in any way, shape or form stops or cures the disease.

(30:31):
So a lot of people will have recurrence after their pregnancy and sometimes their symptomscharge back within a few months.
um You know, I know personally, I didn't have my menstrual cycle while I was breastfeedingfor the first year.
but some people, regardless of that, will just have these horrific cycles even a fewmonths after giving birth.

(30:52):
it can be, yeah, it can be a moment of reprieve and time being pregnant, but certainly nota cure.
That's interesting that being pregnant would like make it go away for a while.
That's pretty wild.
Yeah.
I mean, it affects the way those cells are grown, I guess, right?

(31:14):
Because it's uteral cells.
Am I saying that right?
Uterine cells.
Endometrial sounds.
Endometriacy.
We learn things on the fly here.
But I mean, getting pregnant would change the way those cells are behaving, I guess, in away, right?
Because I mean, it's just I'm a logician in my way.

(31:39):
I can solve puzzles.
They do have a hormone engine in these cells.
They are driven by estrogen in the absence of progesterone, but it is localized to thatcell.
It's not necessarily driven by your own estrogen.
However, pregnancy can do a lot of things, including suppress your immune system and yourimmune responses in the body.

(32:04):
And yeah, just a lot of lovely hormones and um chemicals are induced during pregnancy.
And so there's a lot of things in terms of pain management, reduced inflammation, um youknow, all sorts in terms of the symptoms that just kind of go quiet and remain quiet as a
result.
And I think that hormonal pieces is probably why.

(32:28):
Hormone birth control does work for some people because instead of you going through thesehormone fluctuations, which then ticks off, like pees off these lesions and gets them to
play up, you can flatten that curve.
And so it may not completely eliminate your pain, but it may mean you don't have big painflares or pain spikes as a result of the hormone fluctuations in your body.

(32:48):
And that's, what pregnancy is doing.
Like you said, you just go into this kind of homeostasis place with your hormones.
interesting.
Yeah.
And on the flip side of that pregnancy, you had mentioned induced menopause being asolution, maybe an answer to eliminating or because I know you said you can't really get

(33:10):
rid of it, but can so having a hysterectomy, I'm assuming is what that means.
Oh, or no.
So two things, two things.
You can induce menopause medically.
So you can basically take hormones or pills, medication.
hormones because they're not natural, um but medication to induce menopause, to shut downthe parts of your brain that trigger your hormonal cycle.

(33:39):
um It's the same as, it's not same, it's in the same way we change, alter the brain statewhen we take just the pill for birth control.
It's controlling our menstrual cycle.
um So, or you can have a hysterectomy and some,
people do get to the place where it's just so unbearable and their symptoms and theirperiods are so unbearable that they choose to have a hysterectomy.

(34:04):
Neither induced or physical hysterectomy is actually a full cure for the disease.
It's horrific.
That is, it's still not a guarantee that you get a full cure or you will live, you know,endo free for the rest of your life.
Cause like I said, that hormones is just one part of it and
the lesions are not just on your uterus and your ovaries, they can be anywhere.

(34:26):
And they can still grow without um those hormonal um swings happening, because they areself-sufficient in their hormone generation.
um So yeah, pretty extreme methods.
However, like I said, some people's cases of the disease are so severe and they're nowbattling such chronic

(34:51):
know, menstrual conditions and pain that it does get to that place where it's like, pleasejust cut it out.
Please just stop it.
Please remove it.
Like just remove it like I'm done.
And it's just so tough, especially when you're potentially young, potentially pre yourfertility journey.

(35:15):
Yeah, but they do use short periods of induced menopause to
help control certain things around some people's medical journeys.
And I know that that can be effective for some people, but it comes with some prettyhorrific side effects because it's like being thrown into menopause.
eh

(35:36):
the
when designed to go through it, they go through when they're not.
Yeah, as you can see, we have a lot of blunt tools for what is a very complex disease.
really, we're getting by and we're managing, but that's why the community is so loudbecause nine times out of 10, someone's journey is pretty damn horrific from everything

(36:05):
from.
waiting in the gaslighting to the symptom, symptom management and blunt treatment optionsand then having to undergo surgery as well.
So yeah, it's, it's a lot.
So aside, mean, so you've got endo 45, you've got this app that is allowing people whoeither have been diagnosed with endo or maybe haven't yet.

(36:31):
or having all the telltale symptoms, you know, it helps them advocate for themselves.
It helps create more of a, you know, uh concrete information.
Like, yeah, these symptoms are real.
It's actually happening to me to further these, maybe the increase or maybe shortening thetimeframes of somebody getting diagnosed and then treated properly for endo, which is

(36:52):
amazing, right?
Like sounds to me like this is a huge part of the problem, right?
Because you've got tools.
once somebody is diagnosed, whether through surgery, some of these very, um, extreme, youknow, uh, you know, induce menopause, things of that nature.
But beyond that, like what else is happening for ND and O in the universe right now tohelp give it a bigger platform, give it a bigger voice and, and, and help kind of further

(37:21):
the treatment and the diagnosis of the condition.
So there is a lot of lobbying happening.
like a lot worldwide.
Yeah, because in like, it almost needs its own roadmap.
And some countries like Australia have set that out to have an endometriosis roadmap thatis a government initiative, which largely involves, you know, more money into research,

(37:46):
things like that, more money into the not for profits and the places and support avenuesfor people.
But also the creation of what they call endometriosis clinics.
Like I mentioned, it is
a, it requires an integrative approach.
Like it requires everything we tell in the app plus your medical journey to reallyovercome the disease.

(38:08):
And they're starting to clue on that people who have best results have gone down amultimodal or integrative path and like used everything that's within their control to
navigate the disease.
So they say, well, why not put clinics like that together?
Let's have pain specialists, let's have natural paths, let's have
dietitians, let's have our gynaecologists and specialists there as well.

(38:30):
um Let's have psychologists because the mental health aspect is huge as well.
So creating and setting up those hubs, I guess, where people with endometriosis can go isa big piece that countries and governments can do.
However, again, this is kind of like,

(38:51):
only serving a percentage of the population, especially if they're potentially privateclinics, right, or in certain locations.
And so really, fem tech, which I think everyone is starting to clue onto, needs to be abig piece in solving this puzzle and being right there, right up uh alongside the sufferer
in their journey day in, day out, and be immediately accessible, be affordable, be thingsthat put them back in control, like.

(39:20):
everything from how can they test and understand certain things to have a consult with apractitioner to, you know, use our app and get all the gold and start building new healthy
habits that are going to help them fight endo.
That all really, when we're talking about how many people globally are impacted, that'skind of where things start to shift the dial.

(39:44):
We're seeing some really awesome new ways to diagnose that won't mean people, a lot ofpeople won't need surgery.
And once those hit the market, that's amazing and it's great.
And it's going to enable a lot of people to have a lot of answers a lot sooner, but italso means we'll potentially have a lot more people who know they have endometriosis
showing up to the doors of medical systems who are completely under-resourced.

(40:10):
You know, we hear about it all the time in the UK, the wait times to just see agynecologist have just shot up to two years.
um Two years.
Yeah.
Two years to even get seen for like an initial.
Yeah.
Yeah.
Good Lord.
That's yeah.
Deeply concerning.

(40:30):
Two years?
Like you've already had a couple kids by then.
In New Zealand, you go in a lottery to get your surgery, like a literal lottery.
So like, if you're in the public, private public system, sorry.
So it's like, you're just waiting for your number to get drawn.
So yeah, it can be a few years.

(40:54):
So yeah, it's, it's like, we really need all of us.
We need everyone everywhere.
Everyone from the people just
you know, continuing to tell the story, continuing to make it real for everyone globallythat this condition does exist.
It is real and this is how it impacts us.
Right through to working in schools and corporates, which is some of what I do as well,going into businesses and helping educate and understand and train and lead them with

(41:21):
tools like Endo45.
And then right through to giving, you know, giving this endometriosis community things attheir fingertips that they can take control.
the disease with.
um support the people, right?
Yeah.
have that volume to doing the research.
There's a lot of interesting research which is happening at the intersection of why theimmune system welcomes those rogue cells rather than clears them out and what is the

(41:51):
dysfunction there that's happening.
And I think whoever cracks that is probably onto a real root cause treatment.
that may definitely shape how we manage endometriosis in the future.
So yeah, that's an interesting one to watch.
Have you heard from providers, doctors, physicians who have patients using your app thathave said, thank you, basically, like you just made my job easier or like your app is

(42:22):
helping to save lives.
I mean, quite honestly, based on some of these severe symptoms.
Definitely saved.
quality of life, right?
It can be transformative when you give someone back control.
Yes, so the practitioners on our medical advisory board are there because they believejust that.

(42:44):
They're like, this is everything I need my patients to know that I don't have time to tellthem.
I don't have the necessarily all of the knowledge or the capabilities to tell them.
I
Even if I did, I certainly couldn't tell them in a 30 minute meeting where we need to befocusing on their surgery and some of this more important stuff.
So, but damn do I wish they knew all this, right?

(43:05):
um And I guess that's why they're there.
That's why they support us.
And we're very much looking for um more and more practitioners to join the bandwagon andto recognize that tools like this can be really good supplementary or
things that they give to their patients when they see people suffering with Endo.

(43:32):
Can I ask a tangent question?
You said at the beginning, you aren't even really originally from the healthcare space.
You were an engineer.
What kind of engineer were you and how hard was it to trans obviously you've been in thehealthcare space a while.
Cause you're talking like an expert on some of this stuff.
ah How hard was it to make that transition?
And do you find that your skills as an engineer help in building a product like endo 45?

(43:59):
Yes, um so I was an energy engineer actually, so um a process engineer by a degree andthen worked in like the energy industry for 10, 15 years and 100%.
I'm the kind of engineer that has a knack for being able to see the bigger picture, see aprocess from like a bird's eye view and then be able to break it down into really simple

(44:26):
pieces and almost
find where it's inefficient and then reverse the inefficiency.
I was called the efficiency lady.
I built like a brand new innovation system and team here in New Zealand and actually wonawards for that, which was kind of sidelined to all of this.

(44:49):
But it was that knack that said, know, well, the human body is just another system.
And when it comes to endometriosis, they say, you know,
got 99 problems and endometriosis is just one because there's all these other systems inthe body that are out to lunch and dysfunctional and they actually need the priority

(45:10):
treatment from you and it's you that's in control of those systems because they're yourbodily systems not the medical people.
So I was like right well okay I guess this is my just my next big reverse engineeringchallenge and how do I crack this code and where do I find the inefficiencies.
and where do I get them back to optimal?

(45:33):
So yeah, those things translated and was it hard?
I think what was really hard was being at the height of my career when being slammed witha stage four endometriosis bus in a male dominated environment where the company hadn't
even heard of the word endometriosis, almost losing my relationship, almost walking awayfrom that career and then having this gold moment where...

(45:59):
I'm in tears in my boss's office and I'm explaining to him what's going on with me and howI just can't cope anymore.
This is before I even know what I have because I've been dismissed by a number ofpractitioners at this point.
And he does something completely unexpected and leans in and says, how do I help andsupport you?
And in that moment, it changed the trajectory of my life because I was then, he enabled meto carve out a career that really worked for me because for a lot of us, it requires

(46:28):
flexible workspace and an understanding workspace to thrive because we can not show upwith 150 % every day of the month when we are battling in the metro.
So this is just not going to happen.
So how do you work in a high performing team environment and how do you sort of like beable to bring your best self on any given day and for the company to still be able to get

(46:53):
value out of that.
So that's a big piece of my journey and
I've sort of lost the original question, sorry about-
no, that was great.
That was exactly that.
You got it.
answered the whole thing.
Yeah, no, that's it makes sense.
Yeah, that may be important.
Oh, sorry.
Good.
I was just going to say it's just so important to have those support people on yourjourney.

(47:16):
Like your power is in your people, especially when the medical system is not showing upfor you.
need you need good backing and support because uh some days are really tough to show upfor life.
I bet.
Yeah, it sounds like it.
And you had a great uh boss, obviously, who was thoughtful.
And I've been thinking about while you've been talking about your distribution channelsfor Endo 45, are you going directly to patients?

(47:43):
Are you going through providers so that those are physicians or practitioners?
think it's the term em that's our different uh global terminologies, right?
Yes, sorry.
em
Yeah.
And I work in the healthcare world and so it's like PCP primary care physician.
What word are we going to use?
Doctors.
um But do you go straight to them and to like gynecologists or other ones and say, Hey,you should, you should, you know, tell your patients or whatever.

(48:13):
I'd love to hear kind of how you get it out there in the world.
So people know how to get it, how to use it.
So right now our main aim is to get it.
directly into the hands of people who need it.
So anyone can just download it from the App Store, either App Store, Google or Apple rightnow today.
And in New Zealand, yes, we are aligning with practitioners.

(48:35):
We are getting it in their waiting rooms.
We want to be in every GP office um so that it's a tool and a resource that is handed onthrough that means too.
And globally, we would like to see that too.
We just feel like we need to
probably approach one country at a time when it comes to the medical system.

(48:57):
yeah, but teaming up with providers, particularly in America would be an amazingopportunity.
And I think key and necessary, I have a lot of our users that would say, know, if mydoctor told me to do this, I would probably put in an extra, you know, 50 or 70 % effort

(49:18):
because...
It's one thing for Juliet Oliver to sit there and be like, come on, you can do it.
And for the app to motivate you.
But it's another for your doctor to be like, and I need you to do this because you alwaystake it more seriously when a doctor's telling you.
Yeah.
And you know, if it's going to better your medical journey as well, why, why not?
Why wouldn't you and your outcomes?

(49:40):
yeah, that makes sense.
I was, I thought about too, and this might be a little ways down the road, but
with a lot of the folks that we interview on the show, they start kind of direct toconsumer and then also bring their products to employers, as like employer provided
benefits for their, especially if you have a really high percentage of women in yourworkforce, like in the healthcare industry, it was very common.

(50:08):
So is that kind of a long-term goal?
Yeah, it's even a short-term action.
I think, know,
In New Zealand, we're doing kind of all three.
We're consumer, practitioner or provider.
We're doing insurance companies and we're doing corporates.
So we kind of do insurance companies.
That was the other one.

(50:29):
I Yep.
I forgot that one.
Okay.
That makes sense.
So now it's just about like, how do we take any of those global?
Obviously B2C it's out there and globally in the world.
So anyone can grab it now, but yeah, it's just.
It's just a time thing, like you said, to move from one country to the next in terms ofthose other pathways to market.

(50:50):
I mean, the app's available everywhere already though, right?
Like people can download it.
Like maybe their practitioner provider doesn't have it yet, but they can have it.
So that's a start.
Yes, 100%.
And the interesting thing about the endometriosis community and something I sort of postedabout the other day is that there was a survey done and 85 % of people responded said that

(51:15):
they learnt everything that was useful on their endo journey and the most practicalinformation and useful information from social media, not from their practitioners and
doctors.
And if people are then taking what they see on social media and implementing it in theirlives and finding change or seeing change and feeling change, then we're in a place right

(51:39):
now in this particular community, this particular disease where self-driven advocacy,change, implementation and learning is actually what we're doing.
It's just where we're at.
It's the gear we're in.
And so I just go, hey, everyone.
Like everyone that was like me, please like have this, have my gold, learn it, know it,get it in your lives and don't wait for answers from anywhere else because they're gonna

(52:08):
be potentially a long time coming.
Yeah, there's, I feel like there's a lot more people with social media, like influencersthat are talking about their specific medical health journeys about, could be endo, could
be, there's a number of other things.
I think having those voices is really important in helping, you know, even companies likeyours, right?

(52:32):
Like just in the general kind of scheme of things, right?
Like endometriosis, I'm going to do, Endo, endo, endo, endo, endo.
Getting endo just, you know, a bigger, bigger, bigger platform and, uh you know, sharingthe stories, right?
Like this is what's happening.
You know, these are real, real people with.

(52:54):
uh
real conditions and, um, you know, bringing it to the masses.
So I love it.
Are there any big milestones, achievements that you are coming up on that you said you hadlaunched a year ago?
I'm assuming you launched the actual app a year ago.
Is that right?
Okay.

(53:14):
Yeah.
Any, any big kind of big milestones coming up or anything like that, that you want to talkabout?
Yeah, so actually we're about to initiate or have soft launched our impact um campaign orprogram where we're going to offer, we're going to start offering the app for virtually

(53:37):
free or extended extended free period and then a really, really minor ongoing subscriptioncost in countries where, you know, um
it's really underserved.
Like these women are just really underserved and really, really, really unlikely to beable to access good care or sometimes even, you know, good, not even good endo care, but

(54:04):
just good menstrual or women's health or hormonal care.
And so um we are, we've started with India.
There are 43 million people who suffer in India alone.
And so we've,
put the app out there for free and we hope that, you know, we can really have an impact.

(54:28):
We can actually start to give back in some countries where we know the barriers toaccessing this sort of stuff is just so high.
That's amazing.
Yeah, you don't hear people giving stuff away for free much these days.
In order to make this impact program work, kind of need someone somewhere else in theworld going, right, I'm going to get a subscription to this app because no one is going to

(54:58):
help me, but I'm going to help someone else who can't afford it.
yeah, it's really important.
Great approach.
love that.
Access is everything.
I mean, can't work for free, but you know, if you can give part of it away and, and, andthen, and, know, really it helps build awareness um ultimately.

(55:20):
Right.
So the more people know about it, the better.
Yeah, that's amazing.
um Well, this has been uh very, you know, I say, Mike, this conversation was enlightening.
I mean, they are, we learned so much um by meeting people like you.
and who are building these apps and this technology and the innovation that comes, youknow, in healthcare.

(55:46):
I feel like every single episode, not only do we learn something, but we do bring thatawareness uh out to the universe.
And so this is definitely a huge part of the show.
so endometriosis.
There you go.
it.

(56:06):
That is definitely, I think it's definitely an area that needs more love.
So we're happy to give you the platform here to talk about it and help get more word outthere on the street about it and help more people get better, try to live a better life,
right?
Yeah.
Yeah.
And especially after hearing the staffs, like we all know somebody who's suffering fromthis.

(56:30):
I didn't even realize that, but one in seven women, everybody knows someone who, who'ssuffering from this.
yeah, we should all get behind this and 045, man, let's get behind it.
Yeah, yeah, that's amazing.
Well, um Juliette, thank you so much for coming on.
This has been a really, really great uh conversation.

(56:51):
But before we say goodbye, will you share with us and our listeners the best place to findyou online?
We know we can download the app, but any kind of information like that we can leave withour listeners today.
Yeah, sure.
So we're at indo.45 on Instagram.
this Endo on LinkedIn and um Facebook.

(57:16):
So yeah, follow along and equally you can follow me at Juliet on LinkedIn, Juliet Oliver.
But yeah, most importantly, just the most direct place to find out more about us isendo45.com or just download Endo 45 from your app store.
Wonderful.
And tell your friends, like Jeremy just said, everyone knows somebody who has it.

(57:40):
If you know anybody, make sure you let them know about endo 45 and, help them, uh, help,help.
is the word you say?
Help me help you.
But, help us help.
Yeah, exactly.
Awesome.
Well, Juliet, thanks again.
This has been a great, great chat today and, um, we've all learned something new today.

(58:01):
So, awesome.
Thank you so much.
And there you go, our conversation with Juliet from Endo 45.
uh Very enlightening conversation.
I didn't even know what endometriosis was before.
Now I know that I know people who have it.

(58:22):
Even though I didn't.
And now you can say it.
Endometriosis.
I can, can you?
endometriosis.
There you go.
It's all about practice, man.
But what are our main takeaways from that interview?
Honestly, I think one of the biggest things, and I think you were also equally as flooredas how common it is.

(58:44):
Yeah.
I, I honestly, I I've known what it is for years.
I'm a woman.
It's, you know, we talk about these things.
I've known people who have it, but truly never considered, um, that there's just a highnumber of people who have it and also the severity of the symptoms and just thinking about
how many people are experiencing symptoms from endometriosis.

(59:08):
and you don't know or they're hiding it.
Like to me, that's just, that's just crazy.
And it's, kind of hurts my heart a little bit because that's a lot of people living in alot of pain and discomfort.
Yeah.
And there's no real diagnosis for it.
Everybody tries to call it something else by individual symptoms, get diagnosed asdifferent things, as opposed to them realizing it's really just one thing that's causing

(59:30):
all these problems.
10 years to get a diagnosis.
Like that is a huge part of someone's life.
And to spend it in anguish like that without having any resolution or answers and
Getting passed from doctor to doctor.

(59:51):
No one actually solving your problem Man, this app is a big deal for these people.
It really is I think
I think it's a reminder to that the how women's health has just been so under served understudied.
You know, this comes up a lot in our show because we cover so much stuff around women'shealth and you know, like the different, you know, conditions and cancer research, blah,

(01:00:23):
blah, blah, all the things that
are specific to women where women weren't even included in studies until like the midnineties, like what the heck.
But, um, but that's changing.
Um, you know, end of 45 is part of that.
in a big way apparently according to this podcast.
A really big, really big way.
And also, too, I think it's really cool that you've got, you know, folks like Juliet andum others creating these apps that specifically target these medical conditions, like

(01:00:48):
really kind of like niching out um in the health care space and using technology and A.I.
and all those things.
um You know, we say like there's an app for everything, right?
Why not in health care?
So there's an app for everyone.
If you have endometriosis, there's an app for you.
to help you manage those conditions.
So it's pretty cool to see that kind of evolution in healthcare, know, really.

(01:01:13):
in her crossover from engineering into the healthcare space and as an engineer coming upwith solutions to healthcare issues is such a great crossover.
really it's, you know, it's unfortunate for her.
She had to go through it, but Juliet's struggle with endometriosis is going to lead to

(01:01:34):
You know, who knows how many multitudes of other people finding a solution to theirendometriosis now.
like her, her curse is such a blessing to everybody else with this disease.
You know what I mean?
And like, and it's tough for her, but she's, she's going to help so many people with that.
And, and, and I think the fact that she was an engineer and not in the healthcare space,you know, like it is, is a big part of the reason why endo 45 exists.

(01:02:00):
Yeah, it's pretty cool.
So it's a cool origin story of the app as it were.
get a lot of those, I think with a lot of the founders that we meet.
And, and also the other thing that seems to be a consistent theme is the quality of timethat is being created for patients with their providers and the efficiency that is being

(01:02:22):
created for those 15 minutes, you know, that you get every time you see your PCP orspecialists or whatever, you know, they've got limited time.
so these apps like endo 45, the technology is.
um It's just, creating, it's creating efficiency in the healthcare ecosystem and it'sliterally changing lives.

(01:02:44):
Yeah, you got the niche ones like this, you got the general ones like the guava that wedid the two-parter on, you know, just so many, and you know, the sidebar health that is
more for the provider side that is giving them access to more people's stories and thatthey wouldn't have otherwise.
And yeah, it just makes doctor appointments so much more efficient.
You walk in and go, here's my history, here's what's wrong.

(01:03:05):
I've got the tests done.
What do we do?
And then you have the whole 15.
15 whole minutes that you get with your doctor, you can get straight to the point.
He already knows what the issue is and you can deal with it directly instead of spendingthat 15 minutes going, wait, when was my last appointment?
Who did I talk to last?
When was my last symptom?

(01:03:25):
yeah, I mean, and it's again, unfortunate that the system doesn't do that for us, but thefact that there are people out there giving us the power to do it for ourselves is a
wonderful.
Yeah, we are we are taking control of our health care in so many different ways and and 45is certainly uh stepping up to the plate there so
So hopefully this helps uh some listeners out there.

(01:03:46):
if you know anyone suffering from this, please send them to this podcast and have themlisten to this episode.
And I'm not just saying that because we want you to hit the happy little fun buttons thatthe likes and subscribes and shares and whatnot share it because they need it.
we're also on all the audio platforms.
We are on YouTube.

(01:04:07):
We have a Patreon where you can help support the uprising for as little as a dollar amonth goes up from there.
So anyway, you want to access us.
are around pretty much everywhere.
um Where else are we Heather?
We have a website that's currently in development, healthcareuprising.com.
It counts.

(01:04:27):
And we're also all over social media.
You can find us on LinkedIn, Blue Sky, Facebook and Instagram.
Just search healthcare uprising podcast and you'll find us.
We post a lot out there so you can stay up to date on when we're dropping new episodes.
um Also, if you have a story to tell, if you're a founder, if you

(01:04:48):
work in the healthcare industry and you're doing something innovative and cool and forwardthinking, we'd love to talk to you.
So please give us a shout out on email, healthcareuprisingatgmail.com.
And we'd love to schedule some time to meet with you and bring on the show.
Also, if you're just a regular old human walking around this earth and you've got a greathealthcare story for good or for bad or both, give us a call.

(01:05:16):
We'd love to talk to you too.
So email us at healthcare uprising at gmail.com for that.
And we'd love to bring you on as part of our human series.
And with that, yes, a bonus.
Yes.
We'd to drop our bonus episodes.
Those human stories are really important to what we're doing here on the old pod.
Um, so yeah, so I think that's it.

(01:05:37):
That's your, that's your dose of, healthcare today.
And, with that, keep looking for the good in the world.
because sometimes it's where you least expect it.

(01:06:44):
This has been a Shut Up production.